Ireland Japan Association | Online Membership Registration

Membership Registration

Fill in this short form to apply for membership of the Ireland Japan Association

Payment Options*
- Pay Online Now
- Pay later
Which category of membership do you qualify for?*
Which category of membership do you qualify for?*
Corporate Applicantion Details
Company Name*
Name and Title of Company Representative*
Company Description*
Corporate members are entitled to have their logos and contact details displayed on our website. Do you agree to this?*
- Yes
- No
Applicant Details
Name of Applicant*
First Last
Phone*
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Fax
Email*
Reason for application*
Year of JET participation (if applicable)
Student Card Number (if applicable)
How did you hear about the IJA?*
Please select
Other:
Please let us know where you heard about IJA
Data Protection Terms & Conditions
Data Protection Terms & Conditions Under the terms of Data Protection Legislation, the Ireland Japan Association will use contact information provided to it by its members for the purposes of the Association and will not release it to third parties without the consent of the members concerned. From time to time, members request contact details for other members and these are provided on the understanding that they are for the purposes of the Association.
Tick here if you agree that your contact details are shared with other IJA members but not with 3rd parties outside the IJA network
- please tick here.
Total
€ 0.00
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Data Protection*
This form collects your details above so we can contact you back in relation to your booking. Please see our privacy policy for more information.
- I consent to you collecting my details above. *
Email
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